Original Research

Third-party disability: An analysis of speech-language therapists’ experiences in adult dysphagia management in South Africa

Kim Coutts, Daniella Meyerowitz
African Journal of Disability | Vol 15 | a1841 | DOI: https://doi.org/10.4102/ajod.v15i0.1841 | © 2026 Kim Coutts, Daniella Meyerowitz | This work is licensed under CC Attribution 4.0
Submitted: 26 August 2025 | Published: 31 January 2026

About the author(s)

Kim Coutts, Department of Speech Pathology, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa
Daniella Meyerowitz, Department of Speech Pathology, Faculty of Humanities, University of the Witwatersrand, Johannesburg, South Africa

Abstract

Background: Dysphagia, a swallowing impairment, has left people in need of assistance and care. Therefore, the lives of caregivers to those individuals with dysphagia change drastically. There is scarce research about the difficulties experienced by caregivers in caring for their loved ones with dysphagia, a phenomenon known as third-party disability (TPD).
Objectives: This study explored Speech Language Therapists’ (SLTs’) experiences with caregivers when managing adult patients living with dysphagia in South Africa.
Method: This study made use of a qualitative approach through an online survey with an optional follow-up interview using an adapted framework of the International Classification of Functioning, Disability and Health (ICF) model. Thirteen participants took part in the survey and two completed the follow-up online interview. Data were analysed using a top-down thematic analysis approach.
Results: Third-party caregivers receive counselling at various times with different content because of the lack of a standardised counselling protocol. Furthermore, using the ICF framework, the article identified that environmental, and contextual factors contribute to TPD. However, not all ICF components were applicable, and additional relevant factors were not captured.
Conclusion: Understanding SLTs’ experiences in managing TPD in the adult dysphagia population was achieved.
Contribution: The study contributes to literature regarding TPD of adult patients living with dysphagia and has captured the role of the SLT in managing TPD in diverse settings across South Africa.


Keywords

dysphagia; third-party disability; third-party caregivers; counselling; ICF framework; South Africa

Sustainable Development Goal

Goal 3: Good health and well-being

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